Doc's Moral Beliefs: Patient Dilemma?

Feb. 7, 2007 -- A doctor's beliefs may affect his or her willingness to
present all the medical options -- including controversial procedures such as
abortion -- to patients, according to a survey from the University of
Chicago.

The study is published in the Feb. 8 issue of The New England Journal of
Medicine. It was done by University of Chicago doctors, including Farr
Curlin, MD.

The researchers mailed surveys to 2,000 U.S. doctors, representing all
medical specialties.

The surveys asked what a doctor's obligations are when a patient requests a
legal medical procedure to which the doctor morally objects.

The vast majority -- 86% -- said physicians are obligated to present all the
medical options to patients, regardless of their personal beliefs.

However, 8% disagreed, and 6% were undecided on the issue.

In addition, 63% said it would be ethical for morally conflicted doctors to
"plainly" explain their moral objections to their patients.

And when asked if such conflicted doctors were obligated to refer patients
to doctors without objections to the requested procedure, 29% either said
"no" or were undecided.

Start Talking

"If physicians' ideas translate into their practices, then 14% of
patients -- more than 40 million Americans -- may be cared for by physicians
who do not believe they are obligated to disclose information about medically
available treatments they consider objectionable," write Curlin and
colleagues.

Curlin's team offers this advice to patients: Talk to your doctor about your
views on thorny medical issues before a health emergency forces the
discussion.

"Physicians and patients might engage in a respectful dialogue to
anticipate areas of moral disagreement and to negotiate acceptable
accommodations before crises develop," write Curlin and colleagues.

"Because patients and physicians come from many different moral
traditions, religious and secular, they will sometimes disagree about whether a
particular medical intervention is morally permissible," Curlin says in a
University of Chicago news release.

Curlin is an assistant professor of medicine and a member of the
university's MacLean Center for Clinical Medical Ethics.

About the Study

A total of 1,144 doctors completed the survey -- a bit less than two-thirds
of those contacted.